REQUIRED EDUCATION / EXPERIENCE:

Bachelor’s degree or equivalent in related field and six years’ experience with provider enrollment, hospital and physician billing or health plan experience.

JOB SUMMARY:

To oversee the provider enrollment function with all government and commercial payors and assist with problem identification and resolution of payor related issues involving provider credentialing, physician or hospital billing, and other payor related activities. Oversee hospital contract loading and variance reporting from the MedAssets system. Provide assistance with oversight for hospital and physician charge master maintenance.

MAJOR DUTIES / CRITICAL TASKS:

Oversees all UTMB activities related to provider enrollment with government and commercial payors monthly reports and communications regarding provider enrollment initiatives to departments within the School of Medicine.

Establishes monthly reports and communications regarding provider enrollment initiatives to departments within the School of Medicine.

Establishes protocols  for timely enrollment of new providers in conjunction with the School of Medicine to ensure proper billing and collections for all new providers.

Provides oversight and assistance to Revenue Cycle Operations to address managed care issues. Interfaces with third parties as needed on behalf of UTMB to resolve payment issues.

Assists UTMB departments with updated managed care information and monthly reports regarding changes in contracts for both Faculty Group Practice and Health System.

Provides daily oversight to staff responsible for maintenance of hospital and physician fee schedules.

Assists UTMB with ongoing maintenance and communication of price list for non-covered services.  Helps to validate services are competitively and consistently priced.

Oversees staff responsible for maintenance of MedAssets contract management system and variance reporting.

Provides feedback to upper management regarding section activities through written reports, correspondence and verbal communication.

Performs related duties as required.

WORKING ENVIRONMENT:

Standard hospital, clinical and/or office environment.

SALARY RANGE:

Actual salary commensurate with experience.

Equal Employment Opportunity

UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.

Compensation